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Information about
ERCP
What is an ERCP?
Endoscopic retrograde cholangiopancreatography, or ERCP, is a
specialised technique used to study the ducts or “drainage tubes”
of the gallbladder, pancreas and liver.
During the procedure an endoscope (a thin, flexible tube) will be passed
through your mouth, into the oesophagus and stomach and then into
the first part of the small intestine. This is the area of the bowel where
the ‘drainage tubes’ (“bile duct” and “pancreatic duct”) connect onto
the bowel. A small plastic instrument will then be placed through the
endoscope and passed into the bile duct and/ or the pancreatic duct
and x-ray dye is injected in order to obtain a picture of these ducts.
Sometimes a small cut is made into the muscle surrounding the opening
to the bile duct (“sphincterotomy”) in order to allow better drainage of
the bile duct or to perform other procedures eg: remove stones, biopsy,
place stents (drainage tubes) or stretch narrowing of the bile duct.
What preparation is required?
You should not eat of drink for at least six hours before the procedure
to make sure you have an empty stomach, which is necessary for a safe
examination.
Generally, you should take all your regular medications with a sip of
water, even on the morning of the procedure. However, if you are
taking blood-thinning medications (such as aspirin, persantin,
warfarin or Plavix or Iscover), your doctor will need to discuss
whether these should still be taken in the weeks before the
procedure. Let your doctor know about any allergies you have
to medications (especially antibiotics), iodine or intravenous
contrast material. If you are diabetic your doctor will need
to make special arrangements to ensure that your blood
sugar is managed well around the time of the
procedure. X rays are used as part of the procedure.
Therefore, it is essential to tell your doctor if you
Digestive Health Foundation
could be pregnant.
An information leaflet for patients and
interested members of the general public
prepared by the Digestive Health Foundation
THIRD EDITION 2010
What can I expect during ERCP?
Contact your doctor or the hospital promptly if you are
experiencing any problems after the procedure. The
main complication after going home is pancreatitis,
which can occasionally occur up to 48 hours after the
procedure. This causes severe pain in the abdomen.
Occasionally an infection can occur, which may cause
pain, fevers or chills. If a sphincterotomy was performed
there is a small chance of bleeding. This can occur up to
3 weeks after the procedure. Symptoms of bleeding
include dizziness, fainting or passing blood or black
bowel movements. If any of these symptoms occur your
should let your doctor know immediately or proceed to
the Emergency Department.
You will receive an intravenous sedative to make you
more comfortable. Some patients also receive antibiotics
before the procedure. You will lie on your left side or
stomach on an X-ray table.Most people remember little
or none of the procedure. The instrument does not
interfere with breathing, but you might feel a bloating
sensation because of the air introduced through the
instrument. If you have a pacemaker defibrillater, special
precautions may be needed during the procedure.
What are risks of ERCP?
ERCP is a safe and well-tolerated procedure when
performed by doctors who are specially trained and
experienced in the technique. Although complications
requiring hospitalisation can occur, they are uncommon.
Complications can include pancreatitis (inflammation of
the pancreas), infections, bowel perforation (a hole in
the wall of the bowel) and bleeding. Some patients can
have an adverse reaction to the sedative used.
Sometimes the procedure cannot be completed for
technical reasons. Risks vary, depending on why the test
is performed, what is found during the procedure, what
therapeutic intervention is undertaken, and whether a
patient has major medical problems. Pancreatitis is the
most frequent serious complication and causes pain in
the abdomen. It is usually mild and settles within a
couple of days in hospital with pain relief, bowel rest and
intravenous fluids. However, occasionally pancreatitis
can more severe, and very rarely can even result in
death. Since the risks vary with each patient you should
have a detailed conversation with your doctor about the
risks to you.
What can I expect after ERCP?
If you have ERCP as a day only procedure, you will be
observed in the endoscopy unit until most of the effects
of the medications have worn off. You might experience
bloating or pass gas because of the air introduced
during the examination. Your doctor may recommend
dietary restrictions for 1-2 days following the procedure.
Someone must accompany you home from the
procedure because of the sedatives used during the
examination. Ideally, a responsible adult should stay with
you overnight. Even if you feel alert after the procedure,
the sedatives can affect your judgment and reflexes for
the rest of the day.
You must not drive until the next day.
Digestive Health Foundation
c/- GESA
PO Box 508, Mulgrave VIC 3170, Australia
Telephone:1300 766 176 Facsimile: (03) 9802 8533
www.gesa.org.au
Who can I contact if I have any questions?
If you have any questions or need advice please consult
your doctor prior to undergoing the procedure.
Digestive Health Foundation
This information leaflet has been designed by the Digestive Health
Foundation (DHF) as an aid to people who have been referred for a
colonoscopy or for those who wish to know more about this topic.
This is not meant to replace personal advice from your medical
practitioner.
The DHF is an educational body committed to promoting better
health for all Australians by promoting education and community
health programs related to the digestive system.
The DHF is the educational arm of the Gastroenterological Society of
Australia (GESA), the professional body representing the specialty of
gastrointestinal and liver disease. Members of the Society are drawn
from physicians, surgeons, scientists and other medical specialties
with an interest in gastrointestinal (GI) disorders. GI disorders are the
most common health-related problems affecting the community.
Research and education into gastrointestinal disease are essential to
contain the effects of these disorders on all Australians.
Further information on a wide variety of gastrointestinal and liver
conditions is available on our website – www.gesa.org.au
®Copyright: Digestive Health Foundation August 2010
This leaflet is promoted as a public service by the Digestive Health Foundation.
It cannot be comprehensive and is intended as a guide only. The information
given here is current at the time of printing but may change in the future.
If you have further questions you should raise them with your own doctor.